Dataset Information

Arthroscopic Coracoacromial Ligament Transfer Augmented With Suspensory V-Shaped Fixation System for Chronic Acromioclavicular Joint Dislocation.

ABSTRACT: Chronic acromioclavicular joint dislocations (ACJDs) develop when there is failure of conservative treatment, failed surgical treatment of acute ACJD, or simply missing the treatment in the acute healing phase. There is wide agreement that mechanical fixation alone in chronic ACJD is not sufficient and biological augmentation is necessary. Various arthroscopic techniques for reconstruction of the coracoclavicular ligament have been described, but allografts are expensive, are not available in all centers, carry the risk of disease transmission, and are "dead tissue" with a poor capacity for healing. Autografts are associated with donor-site morbidity and avascular structures. Moreover, these grafts are associated with a high risk of clavicular or coracoid fractures owing to large tunnels. We present an arthroscopic technique to transfer the coracoacromial ligament to the inferior surface of the lateral part of the clavicle in chronic ACJD, augmented with 2 clavicular buttons and a single coracoid button in a V-shaped configuration. The technique has various advantages including better stabilization, anatomic reconstruction, and a minimal risk of fracture of the coracoid and clavicle with small tunnels, using a vascularized graft with arthroscopic control of reduction.

SUBMITTER: Kany J

PROVIDER: S-EPMC6713877 | biostudies-other | 2019 Jul

REPOSITORIES: biostudies-other

ACCESS DATA

Publications

Arthroscopic Coracoacromial Ligament Transfer Augmented With Suspensory V-Shaped Fixation System for Chronic Acromioclavicular Joint Dislocation.

Kany Jean J Selim Hisham Anis HA

Arthroscopy techniques 20190611 7

Chronic acromioclavicular joint dislocations (ACJDs) develop when there is failure of conservative treatment, failed surgical treatment of acute ACJD, or simply missing the treatment in the acute healing phase. There is wide agreement that mechanical fixation alone in chronic ACJD is not sufficient and biological augmentation is necessary. Various arthroscopic techniques for reconstruction of the coracoclavicular ligament have been described, but allografts are expensive, are not available in al ...[more]

PMID: 31485395

Similar Datasets

Project description:BackgroundThe long-term clinical and radiographic outcomes following coracoclavicular (CC) ligament reconstruction for the operative treatment of acute acromioclavicular (AC) joint dislocation remain uncertain. The purpose of the present study was to determine the long-term clinical and radiographic outcomes of CC ligament reconstruction and to identify risk factors for unfavorable outcomes.MethodsWe reviewed 20 cases of AC joint dislocation in 19 patients (18 male and 1 female; mean age, 32.3 years) that were treated with single-bundle reconstruction. The mean duration of follow-up was 12.7 years. We measured the CC vertical distance (CCD) on the anteroposterior view and compared the affected and unaffected sides (CCD ratio). We divided the patients into those with a CCD ratio of <25% (Group 1) and those with a CCD ratio of ≥25% (Group 2). We radiographically investigated the clavicular tunnel anteroposterior (CTAP) angle, clavicular tunnel ratio, and coracoid tunnel orientation on the basis of the entry and exit points at the base of the coracoid. For the coracoid tunnel orientation, we compared center-center orientation and noncenter-center orientation.ResultsGroup 1 comprised 17 cases (85%), and Group 2 comprised 3 cases (15%). At the time of the latest follow-up, Group 1 had a significantly higher mean Constant score than Group 2 (98.2 compared with 90.7; p = 0.038). Of the 3 radiographic parameters, only the CTAP angle was significantly different between the 2 groups (p < 0.0001). Two (67%) of the 3 cases in Group 2 were associated with posterior AC joint displacement.ConclusionsCC ligament reconstruction for the treatment of acute AC joint dislocation resulted in successful long-term clinical and radiographic outcomes. It is important to decrease the CTAP angle and to ensure proper anatomic placement of the clavicular and coracoid tunnels at the time of surgery.Level of evidenceTherapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Dataset Information

Arthroscopic Coracoacromial Ligament Transfer Augmented With Suspensory V-Shaped Fixation System for Chronic Acromioclavicular Joint Dislocation.

Publications

Arthroscopic Coracoacromial Ligament Transfer Augmented With Suspensory V-Shaped Fixation System for Chronic Acromioclavicular Joint Dislocation.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure